Provider Demographics
NPI:1215448139
Name:OFFTHEANGELS, INC.
Entity type:Organization
Organization Name:OFFTHEANGELS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NITISS
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:786-630-8771
Mailing Address - Street 1:8359 BEACON BLVD STE 613
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3067
Mailing Address - Country:US
Mailing Address - Phone:786-630-8771
Mailing Address - Fax:305-397-2297
Practice Address - Street 1:8359 BEACON BLVD STE 613
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3067
Practice Address - Country:US
Practice Address - Phone:786-630-8771
Practice Address - Fax:305-397-2297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health